How Does Chemotherapy Work?

Chemotherapy
uses drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body in order to kill cancer cells. The side effects come from the fact that it destroys normal cells as well as cancer cells. Chemotherapy may be given either alone or along with
radiation therapy. When given alone, it is given in a higher dose designed to kill off cancer cells. When given along with radiation therapy, it is delivered at a lower dose and is designed to make the cancer more sensitive to the radiation.

How Many Cycles Are Needed?

Chemotherapy is usually given by vein, but some forms can be given by mouth. Your medical oncologist will tell you how many cycles or courses of chemotherapy are best for you. Usually there are between 4-6 cycles of chemotherapy given when the chemotherapy is delivered on its own, and up to 10 cycles of chemotherapy when the drugs are given along with radiation therapy. The side effects and amount of time required in the doctor’s office depend on the type of chemotherapy you receive, as well as how many cycles you get and how often.

What Kinds of Agents Are Used?

Chemotherapy agents used in treating lung cancer include:

Cisplatin
(Platinol-AQ, Platinol)

Etoposide
(Toposar, VePesid)

Carboplatin
(Paraplatin, Paraplat)

Paclitaxel
(Taxol)

Docetaxel
(Taxotere)

Vinorelbine
(Navelbine)

Doxorubicin
(Adriamycin, Rubex)

Vincristine
(Oncovin, Vincasar PFS)

Ifosfamide
(Ifex, Isophosphamide)

Gemcitabine hydrochloride (Gemzar)

Pemetrexed disodium
(Alimta)

Bevacizumab
(Avastin)

Erlotinib
(Tarceva)

Gefitinib
(Iressa)

Most treatment regimens will combine two or more of these drugs. The types, dosages, and duration of treatment will depend on the stage and type of your tumor and how well it responds to treatment.

Fever or chills—If your fever is over 100.3°F (37.9°C), call the doctor right away.

Low blood cell counts (eg,
anemia)—If you have low blood cell counts combined with fever, this is a serious side effect that requires emergency care.

The cancer itself or the chemotherapy can cause anemia. This occurs when you have a low number of red blood cells, which carry oxygen throughout your body. Your doctor may treat this condition with a blood transfusion or with medication, such as
pegfilgrastim
(Neulasta) or
epoetin alfa
(Epogen, Procrit). These treatments may be necessary to maintain an adequate blood count, particularly if you get high dose chemotherapy. In general, your doctor will draw blood every week to check your counts.

To manage other side effects, you may need to make diet and lifestyle changes and take medication. For example, your doctor may recommend that you eat several small meals throughout the day and avoid alcohol. Light exercise (eg, walking for 30 minutes) may help to fight fatigue.

Some of these side effects go away soon after chemotherapy has ended, while others linger after treatment.

What About Genetic Testing?

Epidermal growth factor receptors (EGFR) play a role in the development of cells, including cancer cells. Some people who have lung cancer also have a mutation that affects EGFR. Because of this, medicines like erlotinib (Tarceva) and gefitinib (Iressa) have been created to target the action of this receptor. Doctors can test a tissue sample or do blood tests to find out if someone has this mutation. If the result is positive, then treatment with erlotinib or gefitinib may help the person live longer.

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY.
Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

DISCLAIMER: This information is intended for educational purposes. EBSCO is in no way liable for the use of this information and makes no warranty or guarantee as to its accuracy.